Can anyone recommend good pet insurance that covers pre-existing conditions and preventive care?

January 22, 2009 2:46 PM

Is there any decent pet insurance out there? I just paid several appendages to get my cat fixed up and I'm looking to find something that will cover preventive care and not have exclusions based on pre-existing conditions.

So I just had a delightful trip through the veterinary care system - poor cat got blocked up, had a "trautmatic catheterization," and wound up needing emergency surgery and having to be in the hospital for over two weeks before finally needing p/u surgery. Needless to say, this was ridiculously expensive, but fortunately it seems to have actually worked, and he's back to being a happy, healthy cat (well, except when I have to give him pills, which he is not happy about). Frankly, I'm extremely lucky that I have a support system that was able to give me a pay-it-back-when-you-can loan to pay for this, or I would have been paying off American Express for about the next five years.

I'm looking to avoid needing to go down this road in the future. The pet insurance the vet recommended to me didn't seem like a great deal, though, since it was REALLY unclear if it would cover anything if there was a recurrence of blockage (which is unlikely after the p/u surgery, but certainly not impossible) and didn't appear to cover any preventive care. I would love to get something that covered a preventive checkup a year, and didn't have pre-existing condition exclusions.

Anyone have any pet insurance companies they'd recommend I use/stay the hell away from for this situation?

posted by loudguitars to pets & animals (12 comments total)

My mother and I had ASPCA insurance and getting them to pay claims for a fever that my cat had was nearly impossible. Our vet had to fax a bunch of forms 4+ times before they apparently received them, and then they paid less than 50% of our claim because they pay 80% of the prices on their "fee schedule" (which they don't release to the public, so you have no idea what these fees are) regardless of the actual charges from the vet. I'd avoid them.
posted by PhoBWanKenobi at 3:14 PM on January 22

I've been making half-hearted attempts to broker pet insurance on my own for some time, in part because I want to learn about the ins-and-outs of the value proposition. I wish I had more hard info to relate.

I was once given a common-sense lesson in the decision of whether to use pet insurance or not. You basically take the likelihood that your critter will require a high value veterinary service (say cancer treatments - which I spent probably $15k or more over a 28 month period four years ago) versus your ability to raise the sum if indeed your animal required the service.

So do you have $10k worth of stock you could sell? Could you get a credit card with a low rate and put $10k on it? Could you sell your baseball card collection? What are your alternatives for raising $3000, $4000, or $5,000 in time to OK a procedure?

If your options are pretty good (I had some stock to sell, seemed like a perfect use of the proceeds) then insurance might be overkill.

What the insurance does do is it keeps you from having to make the decision. There's never any question that you will OK the vet service because you've got reimbursement coming to you. If you're ambivalent about how much you would have to cough up in the future for work then there is probably a good, fair policy out there for you.
posted by vito90 at 3:24 PM on January 22

I went looking last year for pet insurance that covers pre-existing conditions and concluded it doesn't exist. Maybe there was something I missed or there's something new, but it's hard to find. And for preventive care, I guess it depends what sort of care you get for your pets, but at least for my indoor cats it seemed as if the cost of preventive care was more expensive than just paying up front.

I eventually sucked it up and went with VPI to cover new recurring problems, if not the old ones we already know about, and I'm glad I did. One cat developed diabetes and the insurance coverage for the insulin and syringes and bloodwork has been a big help, and worth it for me even though he won't be covered if he has a recurrence of the one prior condition that's excluded.

I've been happy with VPI other than the pre-existing thing; the claim forms are easy and they haven't given me a hassle about covering any care.
posted by Stacey at 3:46 PM on January 22

I spent a lot of time researching pet insurance companies for my cat after having been socked with nearly $3K in vet bills in just over four months. After reading reviews at PetInsuranceReview.com, I finalized my list and set about to call the different companies to find out their reimbursement rates.

Based on the reviews, Pet Plan and Pet First are the two best companies to check out first. [Disclaimer: We purchased our insurance through Pet Plan. We're paying $134 a year for a $50 per incident deductible and 90% reimbursement of the actual vet charges for our cat, who was 8 months old at the time of signup.]

Pet First: http://www.petfirsthealthcare.com
I looked at Pet First and it seems that they offer coverage similar to Pet Plan, but they also offer wellness coverage (a limit of $100-$200, depending on your plan). Their premiums seem to be better than another insurance company I liked, Pets Best (reviewed below), but I don't know what their exclusions are. There are incident limits, though. I'd call them and talk to the sales reps and see what kind of vibe you get from them. You will especially want to ask about pre-existing conditions.

Pet Plan: http://www.gopetplan.com/Cat-Insurance-Policies.html
They reimburse you on the vet's charges (not a UCF or a benefits schedule) and you can choose the level of deductible you want ($50, $100, or $200). They have a quote generator that you can use to determine your likely cost. You get a 5% discount for getting a web quote and you get another 5% discount if you use the US Humane Society promotional code: SPD20002. If your cat is microchipped, you get a 10% discount. The maximum discount you can get for a single policy is 15%.

Pets Best: http://www.petsbest.com/
Pets Best was also rated highly and they were my "front runner", until I decided that I just couldn't afford wellness coverage. Anyway, they have an incident payment limit of $2,500 for the "basic" plan and $7,500 for the "first" plan. There were no reimbursement limits in a year. They offered wellness care, based on a fee schedule, which would probably get you back about 50% of what you paid for a wellness visit. That upped the price of the premiums, though, to more than $30 a month, which was too much for us. I don't know what they offer for dogs, but they were definitely my second choice. I probably would have gone with them had the premiums with Pet Plan been higher.


VPI: http://www.petinsurance.com/
VPI is offered through my work and is one of the insurance companies that I read most about. It was also the one I found to be most disappointing. It pays out 90% reimbursement with a $50/incident deductible, but reimbursements are based on their benefit schedule, which is determined wholly on a diagnosis. VPI was the only plan that did it this way. Unfortunately, they couldn't give me any idea what they would reimburse me because I didn't know the exact diagnosis. I find this to be terribly inconvenient because how am I supposed to make financial decisions related to care if I don't know what my insurance will cover?

(Pet Plan and Pets Best based their reimbursements on the actual vet fees.)

Premier Pet Insurance: http://www.premierpetinsurance.com/
They pay based on individual vet fees, which are then adjusted to their UCF, with you being responsible for the balance. They have a $100 annual deductible (which is nice!) and reimburse 80% of their UCF. However, they reimburse on the line item, meaning that there may be procedures they don't cover at all. Also, they only issue new policies twice a month, and they have a 30 day wait limit on illness, beginning when the policy is issued.

Also, Premier, Hartford, ASPCA, and PetsHealth are all the same company. My vet explicitly warned me away from the "ASPCA one".
posted by parilous at 4:00 PM on January 22 [18 favorites has favorites]

Also, most insurance companies don't cover pre-existing conditions... but you have to be careful because at least one company (can't remember which) that I talked to said that they would consider incidents that occurred in the previous coverage year to be "pre-existing" -- even if they covered it before! So, definitely ask about that...
posted by parilous at 4:06 PM on January 22 [1 favorite has favorites]

I haven't done any research specifically about pet insurance but what parilous says about pre-existing conditions is true for ALL horse insurance policies. If your horse has an injury or illness one year while you have the insurance, that condition is always excluded from coverage the following year when you renew your policy. This is true even if the injury or illness is minor enough that you do not meet the deductible and do not have to make a claim. I have always assumed that this would be true for pet insurance so I would be sure to ask each company.
posted by horses, of courses at 4:32 PM on January 22

I rejected pet insurance because I felt like it was too difficult to get them to pay, based on anecdotal knowledge and my own vet's assessment over the years.

Understand that almost ZERO vets will accept pet insurance. You will have to pay them and then get reimbursement.

The other thing is, every reputable vet has some kind of no interest pet credit card or Care Credit you can apply for. If they don't then go to another vet.

I can understand having to deal with emergencies (I've just dropped $1k in the past month for my late cat) but if you can't afford yearly checkups you need to revise your budget so that you can.
posted by micawber at 5:29 PM on January 22

I had VPI, and though the claims were easy to file, and they paid out very quickly, I was disappointed in the amount they paid out. If I had just stuck the money in a savings account marked "kitty", to use in case of emergency, I would have been better off. Of course, then my cat wouldn't have gotten a birthday card sent to her every October, though.
posted by OolooKitty at 5:44 PM on January 22

I work in a vet clinic and I know of no pet insurance programs which are worth the money and which do not exclude pre-existing conditions or find some way to get out of paying for things (it's ASPCA, I believe, which doesn't cover events from the previous year, so if your insurance renews January 1, and your dog breaks his leg December 31, you need to sit there with a screaming dog until after midnight if you want your insurance to cover it, and then lie about when it happened - this has happened to two clients where I work). Get CareCredit instead, it costs you nothing to have, almost all vets accept it, and you can use it for your own care too (usually at dentists).
posted by biscotti at 6:23 PM on January 22

The first rule of insurance is that insurance is for risks that you can't afford. It doesn't make sense to buy insurance for risks that you can afford. The insurance costs more than the risks, it's just spread out over many small payments (perhaps the payments of many people in the case of rare/expensive risks) -- otherwise the insurance company wouldn't be making money. So you should only consider it's value in terms of paying for those unaffordable events and not be distracted by other features.

This same principle also means it doesn't make sense to buy insurance for the purpose of paying for something that's certain or very likely to happen (e.g. checkups, conditions likely to recur). You'd just be choosing to pay more.

Any pet insurance I've seen (1) excludes any conditions that the pet has been seen by the vet for in the past 12 months (e.g. I brought the cat to the vet because she was constipated, the vet basically gave us suggestions for how to get her to drink more water and that solved the problem, therefore any insurance we bought in the subsequent year would have excluded any intestinal issues forever) and (2) has low limits on coverage (e.g. a few hundred dollars per illness/injury) unless you get a very expensive plan.

I think you're probably better off taking what you'd pay for pet insurance and every month put it in a dedicated savings account that's only to be used for paying for veterinary treatment.
posted by winston at 6:44 PM on January 22

The other thing is, every reputable vet has some kind of no interest pet credit card or Care Credit you can apply for. If they don't then go to another vet.

Yeah - I applied for that and got rejected, apparently because I have too much unused credit for someone of my income level, and I never carry balances. Which you'd think would be a GOOD thing - I don't use the credit I have unless I actually, you know, NEED it. That pissed me off something awful, and was the main reason I wound up having to go borrow money from my support system.

And it's not about not being able to afford yearly checkups, I just feel like if I'm paying all this damn money for insurance, I'd like them to at least cover some preventive stuff. Though looking at parilous's excellent research (thank you SO much for all that) it looks like I'd be better served by coughing up out of pocket for that and getting a high benefit ceiling emergency plan like the PetPlan one you mentioned.

I think you're probably better off taking what you'd pay for pet insurance and every month put it in a dedicated savings account that's only to be used for paying for veterinary treatment.

I considered this option at first. The problem with this idea is how very much money I just spent and how much I'd be able to put away. I could easily put $50 a month in a savings account, well over what most pet insurance plans I see cost, and not even get $5k in that fund for almost eight years. Given that kitty's recent debacle cost me quite a bit more than $5k, I think I'd probably be better served getting a high benefit ceiling plan.

The preexisting condition stuff is pretty daunting given the litany of issues my little guy's had, though. I'll give some of these places a call and see what they actually would cover. Thank you all for all your help!
posted by loudguitars at 8:28 PM on January 22

Just to clarify, of the five companies I talked to, VPI, PetPlan, and PetsBest did NOT exclude illnesses from one policy year to the next. However, they may treat the illness as one "incident/diagnosis" and if you have a "per incident/diagnosis" limit, your coverage may be limited. So, all three will cover an illness such as diabetes across policy years, but there may be a $7,000 or $11,000 lifetime maximum, after which you would be responsible for all future fees related to diabetes.

Only PetsBest and PetPlan covered genetic conditions and birth defects. Other insurance companies either had limits on when the animal had to first be insured (e.g., as a kitten) to determine whether or not they'd cover it -- they didn't cover it at all. This seems to be particularly important with purebreds.

Also, PetPlan has a slightly lower reimbursement rate for specialty hospitals (which sounds like services you needed for your cat). Their reimbursement for specialists is 80% of actual fees (for my level of coverage, which is 90% reimbursement. I'm not sure if this varies).

One last thing -- it may be worth joining the Pet Assure Discount Plan. With this membership, if you choose a vet that's in their network, the vet discounts their fees (pre-payment) by 25%. Membership is $60 a year, but the discount (apparently) applies to all vet charges, including preventative care. You can use this membership in conjunction with a pet insurance plan, too.

Anyway, pet insurance became a necessity for us. Vet fees are just too much -- to have to make a decision to treat, or not treat, an animal because of the mounting financial concerns is just too heartbreaking.
posted by parilous at 6:05 AM on January 23